KR20050084954A - Thrombin-carrying bioabsorbable synthetic nonwoven fabric - Google Patents
Thrombin-carrying bioabsorbable synthetic nonwoven fabric Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
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- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
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- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
- A61K47/6953—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a fibre, a textile, a slab or a sheet
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- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
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- A—HUMAN NECESSITIES
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- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
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- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
- A61L15/32—Proteins, polypeptides; Degradation products or derivatives thereof, e.g. albumin, collagen, fibrin, gelatin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/64—Use of materials characterised by their function or physical properties specially adapted to be resorbable inside the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
- A61L33/0005—Use of materials characterised by their function or physical properties
- A61L33/0011—Anticoagulant, e.g. heparin, platelet aggregation inhibitor, fibrinolytic agent, other than enzymes, attached to the substrate
- A61L33/0041—Anticoagulant, e.g. heparin, platelet aggregation inhibitor, fibrinolytic agent, other than enzymes, attached to the substrate characterised by the choice of an antithrombatic agent other than heparin
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- A—HUMAN NECESSITIES
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
- A61P7/04—Antihaemorrhagics; Procoagulants; Haemostatic agents; Antifibrinolytic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/418—Agents promoting blood coagulation, blood-clotting agents, embolising agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61L2400/00—Materials characterised by their function or physical properties
- A61L2400/04—Materials for stopping bleeding
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T442/00—Fabric [woven, knitted, or nonwoven textile or cloth, etc.]
- Y10T442/20—Coated or impregnated woven, knit, or nonwoven fabric which is not [a] associated with another preformed layer or fiber layer or, [b] with respect to woven and knit, characterized, respectively, by a particular or differential weave or knit, wherein the coating or impregnation is neither a foamed material nor a free metal or alloy layer
- Y10T442/2525—Coating or impregnation functions biologically [e.g., insect repellent, antiseptic, insecticide, bactericide, etc.]
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T442/00—Fabric [woven, knitted, or nonwoven textile or cloth, etc.]
- Y10T442/20—Coated or impregnated woven, knit, or nonwoven fabric which is not [a] associated with another preformed layer or fiber layer or, [b] with respect to woven and knit, characterized, respectively, by a particular or differential weave or knit, wherein the coating or impregnation is neither a foamed material nor a free metal or alloy layer
- Y10T442/2549—Coating or impregnation is chemically inert or of stated nonreactance
- Y10T442/2566—Organic solvent resistant [e.g., dry cleaning fluid, etc.]
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Abstract
Description
본 발명은 유효성분으로 트롬빈이 고정화된 것을 특징으로 하는 생체흡수성 합성 부직포, 그의 제조방법 및 해당 부직포를 함유하는 지혈제에 관한 것이다The present invention relates to a bioabsorbable synthetic nonwoven fabric characterized in that thrombin is immobilized as an active ingredient, a method for preparing the same, and a hemostatic agent containing the nonwoven fabric.
의료 분야에서, 지혈 관리는 매우 중요하다. 생체 혈관이 손상을 입게 되면, 그의 국소에서 각종 응고 인자가 활성화되고 최종적으로 피브린이 형성되어 지혈에 이르게 된다. 이 과정에서, 트롬빈은 피브리노겐에 작용하여 피브리노겐을 피브린으로 변환시키는 가장 중요한 효소이다. 피브리노겐은 혈액중에 존재하나, 그 자체만으로는 지혈 효과가 없으며, 트롬빈 작용시에 지혈 효과가 발휘된다. 즉, 트롬빈은 생체의 지혈 반응에 가장 중요한 역할을 한다.In the medical field, hemostatic management is very important. When living blood vessels are damaged, various coagulation factors are activated locally, and fibrin is finally formed, leading to hemostasis. In this process, thrombin is the most important enzyme that acts on fibrinogen and converts fibrinogen to fibrin. Fibrinogen is present in the blood but does not have a hemostatic effect on its own and exerts a hemostatic effect upon thrombin action. That is, thrombin plays the most important role in the hemostatic response of the living body.
(발명이 해결해야 할 기술적 과제)(Technical challenges to be solved)
종래의 트롬빈 제제는 액상 또는 분말 형태이어서 출혈 부위에 도포하는 경우 흘러 내려 트롬빈의 지혈 효과를 충분히 발휘하지 못하는 경우가 빈번하다. 이러한 문제를 극복하기 위하여, 트롬빈을 생체흡수성 재료상에 고정화시킨 시트에 대한 다양한 보고가 있어 왔다(예: WO 제 90/13320호 및 일본 특허 공개 제 61/59737호). 이들 시트중 하나는 젤라틴으로 만들어진 시트 재료에 혈액으로부터 유래된 트롬빈을 고정화시킨 것이다. 그러나, 이 시트는 후술하는 실시예에 나타낸 바와 같이, 충분한 지혈 효과를 나타내는데 실패하였으며, 그의 제조 곤란성과 실제 사용상의 문제점 때문에 실용화에 이르지 못했다. 소 젤라틴에 소 트롬빈을 혼합시킨 젤 형태의 지혈제가 있으나, 이러한 형태의 지혈제는 BSE와 같은 감염의 위험과 사용시 압박이 용이하지 않다는 문제가 있다.Conventional thrombin formulations are often in liquid or powder form, and when applied to the bleeding site, often flow down and do not sufficiently exhibit the hemostatic effect of thrombin. In order to overcome this problem, various reports have been made on sheets in which thrombin is immobilized on a bioabsorbable material (eg WO 90/13320 and Japanese Patent Laid-Open No. 61/59737). One of these sheets is immobilized thrombin derived from blood on a sheet material made of gelatin. However, this sheet failed to exhibit a sufficient hemostatic effect, as shown in the examples described later, and has not been put to practical use due to its difficulty of manufacture and problems in practical use. Although there is a gel-type hemostatic agent in which bovine thrombin is mixed with bovine gelatin, this type of hemostatic agent has a problem that it is not easy to pressurize when used and the risk of infection such as BSE.
다른 형태의 지혈제로 트롬빈과 다른 응고 인자를 배합시킨 피브린 접착제가 있다. 주로 트롬빈과 피브리노겐으로 구성된 피브린 접착제는 피브리노겐이 트롬빈 작용으로 피브린으로 변환되는 것을 이용한 생체 조직 접착제로, 접착, 지혈 및 폐쇄를 목적으로 광범위하게 임상 분야에 사용되고 있다. 그러나, 예를 들어 외과 수술에 사용하는데 있어서 트롬빈 용액 및 피브리노겐 용액을 용해하여 제조하는 것은 시간이 걸리고 따라서 특히 긴급시 사용하기에 매우 불편하다.Another type of hemostatic agent is fibrin adhesives that combine thrombin and other coagulation factors. Fibrin adhesives composed mainly of thrombin and fibrinogen are biotissue adhesives that convert fibrinogen into fibrin by thrombin action, and are widely used in clinical fields for the purpose of adhesion, hemostasis, and closure. However, dissolution of the thrombin solution and fibrinogen solution, for example for use in surgical operations, takes time and is therefore particularly inconvenient for use in emergencies.
이러한 불편성을 고려하여, 출혈 부위에 시트를 직접 가압하여 사용되는 피브린 접착제가 또한 실용화중이다. 그러나, 현행 시트형 접착제는 소 유래의 트롬빈과 함께 말 콜라겐, 즉 인간이외의 동물종으로부터 유래한 물질이 기본 재료로 구성되어 이종 단백질에 대한 항체가 출현함으로써 프리온(prion) 질병과 같은 인수공통 감염 위험성이 존재하기 때문에 이상적이지 않다. 따라서, 현 상황의 국소 지혈제는 취급 및 안전성 면에서 만족할만 하지 않다.In view of this inconvenience, fibrin adhesives which are used by pressing the sheet directly to the bleeding site are also in practical use. However, current sheet adhesives, along with bovine-derived thrombin, are composed of horse collagen, a substance derived from a non-human species, consisting of a base material and the emergence of antibodies to heterologous proteins, which is a risk of acquired common infections such as prion diseases. It is not ideal because it exists. Thus, current hemostatic agents are not satisfactory in terms of handling and safety.
상기 언급된 문제들을 해결하기 위하여, 감염 요인이 없는 인간 유래의 응고 인자를 함유하며, 지혈 효과를 십분 발휘하도록 엄선하여 연구되고 생체에 안전한 소재로 만들어진 시트 형태의 지혈제가 요망된다.In order to solve the above-mentioned problems, a sheet-type hemostatic agent containing a coagulation factor derived from humans without an infectious agent and carefully selected to exert its hemostatic effect and made of a material that is safe for a living body is desired.
(문제의 해결방법)(Solution of problem)
본 발명자들은 상기 언급된 다양한 문제를 감안하여 예의 검토한 결과 국소 지혈제에 관한 본 발명을 완성하게 되었다. 즉, 본 발명은 다양한 생체흡수성 재료중에서 부직포 형태로 가공되는 생체흡수성 합성 재료를 선정하여 지혈에 유효한 성분으로 트롬빈을 고정화시킨 생체흡수성 합성 부직포, 그의 제조방법 및 해당 부직포를 포함하는 지혈제에 관한 것이다.The present inventors have made intensive studies in view of the various problems mentioned above, and have completed the present invention regarding topical hemostatic agents. That is, the present invention relates to a bioabsorbable synthetic nonwoven fabric in which thrombin is immobilized as an effective component for hemostasis by selecting a bioabsorbable synthetic material processed into a nonwoven form among various bioabsorbable materials, a method of manufacturing the same, and a hemostatic agent including the nonwoven fabric.
(종래 기술보다 유효한 효과)(Effective effect than conventional technology)
본 발명에 의한 트롬빈 고정화 생체흡수성 합성 부직포는 다음과 같은 우수한 성질을 가짐에 따라 이상적인 국소 지혈제이다.The thrombin immobilized bioabsorbable synthetic nonwoven fabric according to the present invention is an ideal topical hemostatic agent according to the following excellent properties.
(1) 지혈 효과가 우수하다;(1) hemostatic effect is excellent;
(2) 비상시 취급이 용이할 수 있다;(2) easy handling in an emergency;
(3) 안정성이 우수하다;(3) good stability;
(4) 경시적으로 흡수된다;(4) absorbed over time;
(5) 신축성 및 유연성이 우수하다;(5) excellent elasticity and flexibility;
(6) 광범위 영역에서 지혈이 가능하다;(6) hemostasis is possible in a wide range of areas;
(7) 염증 반응이 경미하거나 전혀 없다.(7) Mild or no inflammatory response.
따라서, 본 발명은 다양한 수술 분야에서 조직을 폐쇄하는데 필요한 외과 수술에서 안전하게 지혈을 수행할 수 있는 생체흡수성 합성 부직포를 포함하는 지혈제를 제공한다.Accordingly, the present invention provides a hemostatic agent comprising a bioabsorbable synthetic nonwoven fabric capable of safely performing hemostasis in surgical operations required to close tissue in various surgical fields.
발명을 실시하기 위한 최상의 형태Best Mode for Carrying Out the Invention
본 발명에 사용된 생체흡수성 합성 부직포는 생체흡수성 합성 섬유로 만들어진 부직포이면 되고 특별히 한정되지 않는다. 본 발명의 부직포는 환부에 확실히 피복가능하도록 적절한 유연성을 가지는 것이 바람직하다. 예를 들어, 이러한 부직포를 형성할 수 있는 합성 섬유에는 부직포로 가공후 사용될 수 있는 폴리글리콜산, 폴리락트산, 또는 글리콜산과 락트산의 코폴리머 등이 포함된다. 이들 중에서, 폴리락트산을 부직포로 가공한 생체흡수성 합성 부직포가 본 발명의 목적에 가장 바람직한 소재이다.The bioabsorbable synthetic nonwoven fabric used in the present invention may be a nonwoven fabric made of bioabsorbable synthetic fibers and is not particularly limited. It is preferable that the nonwoven fabric of the present invention has appropriate flexibility so that it can be reliably coated on the affected part. For example, synthetic fibers capable of forming such nonwovens include polyglycolic acid, polylactic acid, or copolymers of glycolic and lactic acid, which can be used after processing into nonwovens. Among these, a bioabsorbable synthetic nonwoven fabric obtained by processing polylactic acid into a nonwoven fabric is the most preferred material for the purposes of the present invention.
본 발명의 부직포 형상은 특별히 한정되지 않으나, 다양한 용도로 응용이 자유롭다는 면에서 시트 형태가 바람직하다.Although the shape of the nonwoven fabric of the present invention is not particularly limited, the sheet form is preferable in that the application is free for various uses.
트롬빈으로는, 인간 혈액 유래 트롬빈 및 재조합 DNA 기술로 수득한 재조합 트롬빈 둘다가 사용가능하다. 트롬빈 이외에, 약제학적으로 허용되는 안정제 및 첨가제가 또한 첨가될 수 있다. 이러한 안정제 및 첨가제의 예에는 예를 들어 알부민, 폴리에틸렌 글리콜, 아르기닌, 소듐 히알루로네이트, 글리세롤, 만니톨 및 염화칼슘 등이 포함된다.As thrombin, both human blood-derived thrombin and recombinant thrombin obtained by recombinant DNA technology can be used. In addition to thrombin, pharmaceutically acceptable stabilizers and additives may also be added. Examples of such stabilizers and additives include, for example, albumin, polyethylene glycol, arginine, sodium hyaluronate, glycerol, mannitol, calcium chloride and the like.
본 발명에 따른 트롬빈 고정화 생체흡수성 합성 부직포는 예를 들어 다음과 같이 제조될 수 있다.The thrombin immobilized bioabsorbable synthetic nonwoven fabric according to the present invention can be prepared, for example, as follows.
트롬빈을 생리식염수 또는 완충액에 용해시키고, 여기에 임의로 알부민, 폴리에틸렌 글리콜, 아르기닌, 히알루론산, 글리세롤, 만니톨 또는 염화칼슘 등을 안정제 또는 첨가제로 추가로 첨가한다. 그후, 이 용액에 생체흡수성 합성 부직포를 침적시키고, -80 ℃에서 2 시간동안 동결후, 동결건조하여 목적 생성물을 수득한다.Thrombin is dissolved in physiological saline or buffer, optionally with further addition of albumin, polyethylene glycol, arginine, hyaluronic acid, glycerol, mannitol or calcium chloride, as stabilizers or additives. Thereafter, the bioabsorbable synthetic nonwoven fabric is dipped in this solution, frozen at −80 ° C. for 2 hours, and then lyophilized to obtain the desired product.
출혈 부위를 본 발명에 따른 트롬빈 고정화 생체흡수성 합성 부직포로 압박하여 압박에 의해 혈액의 유출을 방지하고, 게다가 시트에 함유된 트롬빈이 혈액의 피브리노겐과 반응하여 피브리노겐을 피브린으로 변환시킴으로써 국소에서 지혈 효과가 발휘될 수 있다. 형성된 피브린은 주변 조직과 접착한다.The bleeding site is pressed with a thrombin immobilized bioabsorbable synthetic nonwoven fabric according to the present invention to prevent blood leakage by compression, and furthermore, the thrombin contained in the sheet reacts with fibrinogen in the blood to convert fibrinogen into fibrin, thereby improving the hemostatic effect locally. Can be exercised. Fibrin formed bonds with surrounding tissue.
폴리글리콜산으로 만들어진 생체흡수성 부직포는 이미 의료용으로 사용되고 있으며, 생체내로 흡수되어 물 및 이산화탄소로 분해되기 때문에 그의 안정성이 입증되었다.Bioabsorbable nonwovens made of polyglycolic acid have already been used for medical purposes and their stability has been proven because they are absorbed in vivo and decomposed into water and carbon dioxide.
그 자체로, 본 발명에 따른 트롬빈 고정화 생체흡수성 합성 부직포는 국소 출혈에 간편하고 신속히 대처가 가능하며, 압박과 혈액 응고 반응에 의해 효과적인 지혈을 가능케 한다. 또한, 상기 생체흡수성 합성 부직포에 사용된 모든 재료는 생체에 안전하고 의료 현장에서 안심하고 사용될 수 있다.As such, the thrombin-immobilized bioabsorbable synthetic nonwoven fabric according to the present invention can cope with local bleeding simply and quickly, and enables effective hemostasis by compression and coagulation reactions. In addition, all materials used in the bioabsorbable synthetic nonwoven fabric are safe for living bodies and can be used with confidence in the medical field.
이하, 실시예를 통해 본 발명을 보다 상세히 설명할 것이나, 본 발명이 이에만 한정되는 것으로 해석되어서는 안된다.Hereinafter, the present invention will be described in more detail with reference to Examples, but the present invention should not be construed as being limited thereto.
실시예 1: 재조합 트롬빈의 제조Example 1 Preparation of Recombinant Thrombin
재조합 트롬빈을 일본 특허 출원 제 2001/206,919호에 기술된 바와 같이 제조하였다. 간략하여 기술하면, 인간 프로트롬빈 유전자를 도입시킨 동물 세포를 배양하고, 배양 배지로부터 프로트롬빈을 정제하였다. 한편, 에카린(ecarin) 유전자를 도입시킨 동물 세포의 배양 배지로부터 에카린을 정제하였다. 수득한 에카린으로 프로트롬빈을 활성화하여 트롬빈을 정제할 수 있다.Recombinant thrombin was prepared as described in Japanese Patent Application No. 2001 / 206,919. Briefly, animal cells into which the human prothrombin gene has been introduced were cultured, and prothrombin was purified from the culture medium. Meanwhile, ecarin was purified from the culture medium of the animal cells into which the ecarin gene was introduced. The thrombin can be purified by activating prothrombin with the obtained ecarin.
실시예 2: 트롬빈을 고정화한 시트의 제조Example 2 Preparation of Sheets with Fixed Thrombin
본 발명에 따른 트롬빈 고정화 시트를 다음과 같은 방법에 따라 제조하였다.The thrombin immobilization sheet according to the present invention was prepared according to the following method.
0.001 내지 0.01% 소듐 히알루로네이트(nacalai tesque; 18237-41) 또는 0.5 내지 2% 글리세롤(nacalai tesque; 17018)을 함유하는 용액에 만니톨(nacalai tesque; 21303)을 0.5 내지 1.5%의 최종 농도 및 염화칼슘을 40 mM 첨가하고, 계속해서 재조합 트롬빈을 1000 U/mL의 최종 농도로 첨가하였다. 이 용액을 폴리글리콜산(3 ㎝ ×3 ㎝; 제품명: Neoveil, Gunze Limited, 두께 0.15 ㎜)으로 만들어진 생체흡수성 합성 부직포에 0.05 mL/㎠로 적가하였다. 시트를 -80 ℃에서 2 시간동안 동결후, 동결건조하여 재조합 트롬빈 고정화 시트 샘플로 사용하였다. 또한, 재조합 트롬빈 대신 인간 혈액 유래 트롬빈을 사용하여 혈액 유래 트롬빈 고정화 시트를 제조하였다.In a solution containing 0.001 to 0.01% sodium hyaluronate (nacalai tesque; 18237-41) or 0.5 to 2% glycerol (nacalai tesque; 17018), mannitol (nacalai tesque; 21303) was added at a final concentration of 0.5 to 1.5% and calcium chloride. 40 mM was added and the recombinant thrombin was then added at a final concentration of 1000 U / mL. This solution was added dropwise at 0.05 mL / cm 2 to a bioabsorbable synthetic nonwoven made of polyglycolic acid (3 cm x 3 cm; trade name: Neoveil, Gunze Limited, 0.15 mm thick). The sheet was frozen at −80 ° C. for 2 hours and then lyophilized to use as a recombinant thrombin immobilized sheet sample. In addition, blood-derived thrombin immobilized sheets were prepared using human blood-derived thrombin instead of recombinant thrombin.
대조군으로, 트롬빈으로 처리하지 않은 생체흡수성 합성 부직포, WO 제 90/13320호의 실시예에 기술된 바와 같이 제조된 젤라틴으로 만들어진 지혈 스폰지 및 시판 시트상 피브린 접착제를 사용하였다.As controls, bioabsorbable synthetic nonwovens not treated with thrombin, hemostatic sponges made from gelatin made as described in the examples of WO 90/13320 and commercially available sheet-like fibrin adhesives were used.
그룹 1: 혈액 유래의 트롬빈 고정화 시트Group 1: Thrombin Immobilized Sheet from Blood
폴리글리콜산으로 만들어진 부직포에 인간 혈액 유래의 트롬빈을 50 U/㎠로 고정화시킨 시트를 사용하였다.A sheet in which thrombin derived from human blood was immobilized at 50 U / cm 2 was used for a nonwoven fabric made of polyglycolic acid.
그룹 2: 재조합 트롬빈 고정화 시트Group 2: Recombinant Thrombin Immobilized Sheet
폴리글리콜산으로 만들어진 부직포에 재조합 트롬빈을 50 U/㎠로 고정화시킨 시트를 사용하였다.A sheet in which recombinant thrombin was immobilized at 50 U / cm 2 was used for a nonwoven fabric made of polyglycolic acid.
그룹 3: 트롬빈 비고정화 시트Group 3: Thrombin unfixed sheet
폴리글리콜산으로 만들어진 부직포를 트롬빈 없이 그룹 1과 동일하게 처리한 시트를 사용하였다.A nonwoven fabric made of polyglycolic acid was used in the same manner as in Group 1 without thrombin.
그룹 4: 트롬빈이 고정화된 지혈 스폰지Group 4: hemostatic sponges with immobilized thrombin
WO 제 90/13320호의 실시예에 기술된 바와 같이 제조된 인간 혈액 유래의 트롬빈을 함유하는 젤라틴으로 만들어진 지혈 스폰지(제품명: Spongostan, Johnson & Johnson K.K.)를 사용하였다.A hemostatic sponge (trade name: Spongostan, Johnson & Johnson K.K.) made of gelatin containing thrombin from human blood prepared as described in the examples of WO 90/13320 was used.
그룹 5: 시트상의 피브린 접착제Group 5: Fibrin adhesive on sheet
콜라겐 시트상에 피브린 접착제 성분을 고정화시킨 피브린 접착제(제품명: TachoComb, Toril Pharmaceutical Co., Ltd.; 피브리노겐 및 트롬빈과 같은 성분들이 동결건조에 의해 말 콜라겐으로 만들어진 스폰지 시트의 한쪽 면에 고정화되었다)를 사용하였다.Fibrin adhesive (trade name: TachoComb, Toril Pharmaceutical Co., Ltd .; components such as fibrinogen and thrombin were immobilized on one side of a sponge sheet made of horse collagen by lyophilization), which immobilized the fibrin adhesive component on the collagen sheet. Used.
실시예 3: 삼출성 출혈에 대한 지혈 시험Example 3: Hemostatic Test for Exudative Bleeding
동물의 지혈 평가 모델로 토끼를 사용하였다. 토끼를 개복한 후, 간의 일부를 절제하여 그의 출혈 부위에 실시예 2에서 제조된 각 그룹의 지혈제를 창상 전면에 도포하여 1 분간 압박하였다. 구체적인 평가방법은 다음과 같다.Rabbits were used as an animal's hemostatic evaluation model. After the rabbit was opened, a portion of the liver was excised and the hemostatic agent of each group prepared in Example 2 was applied to the bleeding site and applied to the wound surface for 1 minute. Specific evaluation methods are as follows.
(1) 토끼를 넴부탈 마취하에 개복하였다.(1) The rabbits were opened under Nembutal anesthesia.
(2) 헤파린을 300 U/㎏으로 정맥내 투여하였다.(2) Heparin was administered intravenously at 300 U / kg.
(3) 간의 우엽, 내측좌엽 또는 외측좌엽 표면을 직경 1.5 ㎝의 원형으로 4 ㎜ 두께로 절제하였다.(3) The right lobe, medial lobe or lateral lobe surface of the liver was excised to a thickness of 4 mm in a circle of 1.5 cm in diameter.
(4) 절제 창상으로부터의 출혈을 거즈에 10 초간 흡수시켜 중량을 측정하였다. 절제 창상 형성후 출혈의 양은 약 0.50 g이었다.(4) The bleeding from the ablation wound was absorbed into the gauze for 10 seconds and the weight was measured. The amount of bleeding after excision wound formation was about 0.50 g.
(5) 상기 언급된 각종 지혈 수단으로 지혈을 시도하였다. 각 처치는 구혈을 시키지 않고 혈액이 유출된 상태로 수행하였다.(5) Hemostasis was attempted by the various hemostatic means mentioned above. Each treatment was performed with the blood leaked without bleeding.
(6) 지혈 처치에 필요한 시간을 포함하여 5 분간의 출혈을 거즈에 흡수시키고 중량을 측정하였다. 5 분 경과후 창상면으로부터의 출혈이 관찰되면 지혈 처치 및 출혈 중량 측정을 반복한다.(6) Five minutes of bleeding was absorbed into the gauze, including the time required for hemostatic treatment, and weighed. If bleeding from the wound is observed after 5 minutes, hemostasis treatment and bleeding weight measurement are repeated.
(7) 지혈 처치는 최대 4회 반복하고, 지혈에 필요한 지혈 처치 회수와 지혈 처치 개시로부터 지혈까지의 출혈 총중량으로 평가하였다(표 1).(7) The hemostatic treatment was repeated up to four times, and evaluated by the number of hemostatic treatments required for hemostasis and the total bleeding weight from the start of the hemostatic treatment to the hemostasis (Table 1).
*: 제 4차 지혈 처치후에도 지혈이 불가능한 예가 관찰되었다. * : An example was observed in which hemostasis was impossible even after the fourth hemostasis treatment.
표 1에 나타난 바와 같이, 본 발명의 트롬빈 고정화 시트는 혈액 유래 트롬빈(그룹 1) 및 재조합 트롬빈(그룹 2)을 사용한 경우 둘 모두에서 대조 시트보다 우수한 지혈 효과를 나타내는 것으로 밝혀졌다. 트롬빈 처치되지 않은 부직포만을 사용한 경우에(그룹 3), 지혈 효과는 거의 관찰되지 않으나, WO 제 90/13320호에 기술된 트롬빈 고정화 젤라틴으로 만들어진 지혈 스폰지(그룹 4)보다는 지혈 효과가 우수하였다. 이는 공지된 생체흡수성 재료중에, 본 발명에서 기재로 사용된 생체흡수성 부직포가 지혈 목적으로 가장 적합한 재료임을 나타낸다. 이러한 부직포에 고정화된 트롬빈이 보다 신속하고 효과적인 지혈 효과를 나타내는 것으로 또한 나타났다. 또한, 비교 시험의 결과로부터 명백한 바와 같이, 콜라겐이 기재로 사용된 시트상의 피브린 접착제(그룹 5)는 본 발명의 트롬빈 고정화 시트와 비교하여 지혈 효과가 떨어지는 것으로 나타났다.As shown in Table 1, the thrombin immobilized sheets of the present invention were found to exhibit better hemostatic effects than control sheets in both blood-derived thrombin (group 1) and recombinant thrombin (group 2). When only non-thrombin treated nonwovens were used (group 3), little hemostatic effect was observed, but hemostatic effect was superior to hemostatic sponges (group 4) made of thrombin immobilized gelatin described in WO 90/13320. This indicates that, among the known bioabsorbable materials, the bioabsorbable nonwoven fabric used as the substrate in the present invention is the most suitable material for hemostatic purposes. It has also been shown that thrombin immobilized on such nonwovens exhibits a faster and more effective hemostatic effect. In addition, as is clear from the results of the comparative test, the sheet-like fibrin adhesive (Group 5) in which collagen was used as a substrate was found to have a lower hemostatic effect compared to the thrombin immobilized sheet of the present invention.
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| CA2504812A1 (en) | 2002-11-14 | 2004-05-27 | Juridical Foundation The Chemo-Sero-Therapeutic Research Institute | Thrombin-carrying bioabsorbable synthetic nonwoven fabric |
| EP2052746B1 (en) * | 2004-10-20 | 2014-11-26 | Ethicon, Inc. | Absorbable hemostat |
| US9358318B2 (en) | 2004-10-20 | 2016-06-07 | Ethicon, Inc. | Method of making a reinforced absorbable multilayered hemostatic wound dressing |
| JP2006345745A (en) * | 2005-06-15 | 2006-12-28 | Juntendo | Method for creating hepatic carcinoma non-human animal model |
| CA2711984A1 (en) * | 2008-01-15 | 2009-07-23 | Abbott Gmbh & Co. Kg | Powdered protein compositions and methods of making same |
| JP5437236B2 (en) * | 2008-04-16 | 2014-03-12 | 一般財団法人化学及血清療法研究所 | Method for producing thrombin-immobilized bioabsorbable sheet preparation |
| MX357254B (en) | 2012-05-14 | 2018-07-03 | Teijin Pharma Ltd | Sheet molding and hemostatic material. |
| KR101866571B1 (en) * | 2012-06-29 | 2018-06-11 | 코오롱인더스트리 주식회사 | Biodegradable Non-woven Web, Method for Manufacturing The Same, and Blood Filter Using The Same |
| US9212357B2 (en) | 2012-12-03 | 2015-12-15 | Omrix Biopharmaceuticals Ltd. | Thrombin solution and methods of use thereof |
| CN104027846A (en) * | 2014-06-20 | 2014-09-10 | 东华大学 | Non-woven material reinforced tissue engineering composite three-dimensional scaffold and preparation method thereof |
| US11826028B2 (en) | 2020-06-10 | 2023-11-28 | Ethicon, Inc. | Two component sealing systems including synthetic matrices and biosynthetic adhesives for sealing resected surfaces of organs to control bleeding, fluid leaks and air leaks |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS54104687A (en) * | 1978-02-01 | 1979-08-17 | Unitika Ltd | Novel injury protecting material |
| US4265233A (en) * | 1978-04-12 | 1981-05-05 | Unitika Ltd. | Material for wound healing |
| JPS5844057A (en) * | 1981-08-28 | 1983-03-14 | ユニチカ株式会社 | Material for treating wound part |
| NZ205863A (en) * | 1982-10-18 | 1985-09-13 | Johnson & Johnson Prod Inc | Absorbable haemostatic material containing lactide and glycolide homopolymers and copolymers |
| JPS6395041A (en) * | 1986-10-09 | 1988-04-26 | グンゼ株式会社 | Medical pledget |
| DK223389D0 (en) * | 1989-05-05 | 1989-05-05 | Ferrosan As | SAUCE FUNGI |
| GB9503750D0 (en) | 1995-02-24 | 1995-04-12 | Common Services Agency | Thrombin preparation |
| JP3795100B2 (en) * | 1995-05-08 | 2006-07-12 | 株式会社伊垣医療設計 | Medical suture material |
| JP3526487B2 (en) * | 1995-05-08 | 2004-05-17 | 株式会社伊垣医療設計 | Medical sutures |
| JPH11309151A (en) * | 1998-04-30 | 1999-11-09 | Nippon Waisuredarii Kk | Surgical suturing device |
| US6056970A (en) * | 1998-05-07 | 2000-05-02 | Genzyme Corporation | Compositions comprising hemostatic compounds and bioabsorbable polymers |
| AU755486B2 (en) * | 1998-05-19 | 2002-12-12 | American National Red Cross, The | Hemostatic sandwich bandage |
| CA2504812A1 (en) | 2002-11-14 | 2004-05-27 | Juridical Foundation The Chemo-Sero-Therapeutic Research Institute | Thrombin-carrying bioabsorbable synthetic nonwoven fabric |
| EP1588722A4 (en) * | 2003-01-20 | 2011-03-02 | Chemo Sero Therapeut Res Inst | Hemostatic materials |
-
2003
- 2003-11-12 CA CA 2504812 patent/CA2504812A1/en not_active Abandoned
- 2003-11-12 US US10/534,715 patent/US20060127460A1/en not_active Abandoned
- 2003-11-12 AU AU2003280730A patent/AU2003280730B2/en not_active Ceased
- 2003-11-12 CN CNB2003801031524A patent/CN100356987C/en not_active Expired - Fee Related
- 2003-11-12 KR KR1020057008027A patent/KR20050084954A/en not_active Application Discontinuation
- 2003-11-12 EP EP03772686A patent/EP1563856A4/en not_active Ceased
- 2003-11-12 WO PCT/JP2003/014348 patent/WO2004043503A1/en active Application Filing
- 2003-11-12 JP JP2004551220A patent/JPWO2004043503A1/en active Pending
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2007
- 2007-11-16 US US11/941,779 patent/US8043629B2/en not_active Expired - Fee Related
Also Published As
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|---|---|
| JPWO2004043503A1 (en) | 2006-03-09 |
| WO2004043503A1 (en) | 2004-05-27 |
| EP1563856A4 (en) | 2008-02-27 |
| AU2003280730B2 (en) | 2010-04-29 |
| CN100356987C (en) | 2007-12-26 |
| US20080286347A1 (en) | 2008-11-20 |
| EP1563856A1 (en) | 2005-08-17 |
| CN1711111A (en) | 2005-12-21 |
| US20060127460A1 (en) | 2006-06-15 |
| US8043629B2 (en) | 2011-10-25 |
| CA2504812A1 (en) | 2004-05-27 |
| AU2003280730A1 (en) | 2004-06-03 |
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